treatment for kids

When is the best time to begin orthodontics?

Though a smile can be enhanced at any age, there is an optimal time period to begin treatment to ensure the greatest result with the least amount of time and expense. The American Association of Orthodontists recommends a child’s initial orthodontic evaluation occur at the first sign of orthodontic problems or no later than age 7. At that time, the first adult molars have erupted, establishing the bite of the back teeth. Additionally, enough permanent teeth are present to determine the amount of space for the permanent teeth in the jaw bones, as well as how the teeth and jaw bones fit together. Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention guides growth and development, preventing serious problems later. At this early age, orthodontic treatment may not be necessary, but a thorough examination can anticipate the most advantageous time to begin treatment. When orthodontic intervention is not necessary, Dr. Eberle carefully monitors growth and development and begins treatment when it is ideal.

Orthodontic treatment for kids is divided into two types. First, early treatment is for kids ages 7-10 that addresses very specific growth, development, and tooth eruption concerns. Second, comprehensive treatment is for kids ages 11-17 when all permanent teeth have erupted or are close to erupting and addresses both esthetic and functional components of a child’s smile and bite.

Early Treatment

Every orthodontist has his or her own philosophy regarding if or when early treatment is appropriate. Dr. Eberle treats every child as if they were her own and is very conservative in her treatment planning. She is looking for very specific things in this young age group: Are the permanent teeth present? Are the permanent teeth developing in an appropriate position? Is there enough room for the permanent teeth to grow in to a healthy place in the jaw bone? How do the upper and lower jaws and the corresponding teeth fit together? Is there an overbite or an underbite? Are the upper teeth to the inside of the lower teeth (crossbite)? Is treatment needed now or should treatment be delayed until appropriate growth, tooth eruption, or other factors have occurred? All of these questions are answered at your child’s complimentary new patient consultation.

Only if there is a pertinent orthodontic concern is early treatment recommended. Some of the advantages of early treatment include creating room for crowded, erupting teeth, creating facial symmetry thru influencing jaw growth, reducing the risk of trauma to protruding front teeth, preserving space for unerupted teeth, reducing the need for tooth removal, and reducing treatment time with braces. Treatment appliances for this age group may include limited braces, an upper or lower expander, or other removable appliances used to address an underbite or overbite.

At the end of early treatment, your child will have a retainer that is worn at night to hold the correction. At this time there are usually several baby teeth still present. Dr. Eberle continues to see your child for regular visits every few months to continue to monitor his or her growth and development. Once the child has lost all of their baby teeth and the new permanent teeth grow in, Dr. Eberle re-evaluates what other potential orthodontic treatment might be necessary. Most kids who have early treatment typically have a second phase of treatment that involves full upper and lower braces to perfect both the esthetics and function of their smile.

The upper and lower expanders are described below:

Rapid Palatal Expander(Upper Expander) 

Attached to the upper molars through bonding or by cemented bands, the Rapid Palatal Expander is an orthodontic device used to create a wider space in the upper jaw. It is typically used when the upper jaw is too narrow for the lower jaw or when the upper teeth are crowded or blocked out of the dental arch. When patients are still growing, their connective tissue between the left and right halves of their upper jaw is very responsive to expansion. By simply activating the expander through turning a screw in the center with a special key we provide, gradual outward pressure is placed on the left and right halves of the upper jaw. This pressure causes an increased amount of bone to grow between the right and left halves of the jaw, ultimately resulting in an increased width. 

Schwartz Appliance (Lower Expander) 

The Schwartz Appliance is a removable expansion appliance primarily used on the lower arch in order to expand the arch and create needed additional space for the permanent teeth. Treatment time in the Schwartz Appliance is approximately 9 months, but will vary based on individual needs of the patient. If both the upper and lower arches require expansion, we may use the Schwartz along with a Rapid Palatal Expander in order to coordinate the expansion of both arches. 

Comprehensive Treatment

Comprehensive treatment is for kids age 11-17 when all permanent teeth have erupted or are close to erupting. This treatment is typically thought of as full upper and lower braces. For certain teens, Invisalign is also an appliance option. The purpose of comprehensive treatment is to address both the esthetic and functional components of a smile. The goal is straight teeth that fit and function together. 


Braces come in two types, either traditional metal or clear. The only difference between the two types is the esthetics. Functionally, these two types of braces are equal. Most kids choose metal braces, as part of the intrigue of orthodontic treatment in this age group is the ability to customize the braces by picking different colors to go on each of the braces. That means if you have a favorite color, sports team, upcoming holiday, or are trying to match a certain outfit, we’re here for you! You can even try out our color changer below to sample different color combinations!

Braces Color Chooser

Invisalign® Teen

Invisalign® Teen is a treatment option to correct certain types of alignment and bite concerns. Invisalign® Teen is a series of clear, removable, custom-made aligners that are worn two weeks each to sequentially move your teeth to the proper position. Just like for adults, the key to successful Invisalign® Teen treatment is wearing the aligners at least 22 hours per day, removed only to eat and drink. Essentially, you think about Invisalign® Teen like you think about braces; imagine they are glued to your teeth even though they are removable. One advantage of Invisalign® Teen is that because they are removable, you can still brush and floss normally to maintain healthy gums and teeth. 

Dr. Nicole Eberle is a leading Invisalign® Denver orthodontist and was honored by Invisalign® as a Preferred Provider for 2021, our eleventh consecutive year with this distinction! A Preferred Provider is someone who has reached a distinct level of proficiency and expertise with Invisalign® treatment. We are very pleased to offer Invisalign® Teen to our teen orthodontic patients in Denver, Colorado.


Retainers are essential to maintain the new position of your child’s teeth. Retainers are your insurance policy to ensure that your investment in you child’s smile is protected. At the end of comprehensive treatment, Dr. Eberle uses two different kinds of retainers to maintain the orthodontic correction, removable retainers and permanent retainers. The removable retainers come in two different styles. The first style has a wire on the front and colored plastic on the inside. The second style is thin and clear and essentially looks like an Invisalign aligner. Dr. Eberle determines which style of retainer is most appropriate for you at the end of your comprehensive treatment. The permanent retainer is placed strategically on the back side of certain teeth that are most likely to move as your child gets older. 

Retainer Color Chooser